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特发性甲状腺脓肿——一种罕见病例

Idiopathic Thyroid Abscess - A Rare Occurrence.

作者信息

Chainchel Singh Mansharan Kaur, Vijayanathan Anushya

机构信息

Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, Selangor, Malaysia.

Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.

出版信息

Eur Endocrinol. 2019 Apr;15(1):42-43. doi: 10.17925/EE.2019.15.1.42. Epub 2019 Apr 12.

Abstract

Thyroid abscesses are rare as the gland has a rich blood supply, well-developed capsule and is high in iodine. However, clinicians must be aware of this fact and make an early diagnosis as it can lead to serious morbidity if left untreated. Infection may involve one or both lobes of the thyroid gland, although the left lobe is more often affected and is successfully treated with surgery and antibiotics. This case study involves a 22-year-old woman with a history of painful swelling over the neck accompanied by low-grade fever without any underlying cause. Both the ultrasound and computed tomography revealed a heterogeneous mass within the left lobe of the thyroid gland. Fine needle aspiration revealed an abscess collection and culture Staphylococcus aureus had grown. She was successfully treated with intravenous and oral amoxicillin clavulanate and no surgical treatment was carried out. In conclusion, thyroid abscesses are rare as the gland is resistant to infection and must be differentiated from an infected branchial cleft cyst or sinus, infected thyroid tumour or lymphadenitis in the region of the thyroid in order to avoid serious morbidity if left untreated.

摘要

甲状腺脓肿较为罕见,因为甲状腺血供丰富、包膜发育良好且含碘量高。然而,临床医生必须意识到这一情况并尽早做出诊断,因为若不治疗,可能会导致严重的发病情况。感染可能累及甲状腺的一叶或两叶,尽管左叶更常受累,通过手术和抗生素治疗可取得成功。本病例研究涉及一名22岁女性,其颈部有疼痛性肿胀病史,伴有低热,无任何潜在病因。超声和计算机断层扫描均显示甲状腺左叶内有一个不均匀肿块。细针穿刺显示有脓肿形成,培养出金黄色葡萄球菌。她通过静脉和口服阿莫西林克拉维酸成功治愈,未进行手术治疗。总之,甲状腺脓肿较为罕见,因为甲状腺对感染有抵抗力,必须与感染性鳃裂囊肿或窦道、感染性甲状腺肿瘤或甲状腺区域的淋巴结炎相鉴别,以免不治疗而导致严重的发病情况。

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